Introduction: Evidence regarding the optimal timing of intervention for symptomatic acute necrotic collections (ANCs) in necrotizing pancreatitis remains inconsistent, particularly in the era of minimally invasive step-up approaches. This systematic review and meta-analysis (SR&MA) aimed to compare patient-centered clinical outcomes between early and delayed interventions. Methods: We searched five databases up to 31 January 2025, for clinical studies involving adult patients with ANCs comparing early minimally invasive interventions with delayed interventions. The primary outcome was overall mortality. Subgroup analyses were also performed. Results: This SR&MA included 18 studies [2 randomized controlled trials (RCTs) and 16 observational studies] comprising 2392 patients with symptomatic ANCs requiring intervention. Pooled results demonstrated that early intervention was associated with increased overall mortality [odds ratio (OR) 1.73, 95% confidence interval (CI) 1.34–2.22, P < 0.001, I ² = 4%; 18 studies] and a greater need for open surgery (OR 1.77, 95% CI 1.23–2.56, P = 0.002, I ² = 39%; 11 studies) compared to delayed intervention. However, most studies were assessed to have a high risk of bias. No subgroup differences were found for the primary outcome. Conclusion: Early intervention for symptomatic ANCs was associated with higher overall mortality. Although limited by study quality, these findings suggest early intervention is a potential risk factor for adverse outcomes, warranting cautious clinical consideration.

Pomelo peel (PP), an abundant yet underutilized by-product of fruit consumption, holds immense potential for biomedical innovation due to its porous structure and bioactive compounds. Here we show an eco-friendly transformation of PP into high-performance materials for hemostasis and wound care using scalable manufacturing methods: CO₂ expansion and carbonization. The resulting expanded decellularized pomelo peel (EDPP) sponges exhibit rapid liquid absorption, exceptional porosity, and shape recovery, enabling efficient platelet activation and accelerated hemostasis. In a diabetic wound healing model, EDPP significantly outperformed commercial dressings by enhancing granulation tissue formation, collagen deposition, and wound closure. The carbonized pomelo peel (CPP) aerogels leverage photothermal effects to eradicate bacterial biofilms, promoting the healing of infected wounds. These sustainable materials, derived from agricultural waste, provide innovative solutions for critical healthcare challenges, reducing environmental waste while addressing the global demand for effective wound management systems.

Two antiepileptic metabolites, nordichloridene (1) and 9-chloro-1,2,3,4-tetrahydroacridine (2), were isolated from the marine algae-derived fungus Chloridium sp. NBU3282. Nordichloridene (1) is a new norditerpenoid featuring a bicyclic 6/6 trans-decalin skeleton conjugated with an α,β-unsaturated methyl vinyl ketone side chain. Its structure was elucidated via comprehensive spectroscopic analysis, and the stereochemical configuration was established by NOESY spectroscopy combined with quantum chemical calculations. Compound 2, previously known only in synthetic chemistry, was identified from a natural source for the first time. Both compounds suppressed pentylenetetrazole-induced hyperactivity in a zebrafish epilepsy model, demonstrating antiepileptic potential via acetylcholinesterase activation and the modulation of epilepsy-associated genes.